Combined Assessment of High-Sensitivity Troponin T and Noninvasive Coronary Plaque Composition for the Prediction of Cardiac Outcomes

Gitsioudis, Gitsios; Schüssler, Alena; Nagy, Eszter; Maurovich-Horvat, Pál; Buss, Sebastian J.; Voss, Andreas; Hosch, Waldemar; Hofmann, Nina; Kauczor, Hans‐Ulrich; Giannitsis, Evangelos; Katus, Hugo A.; Korosoglou, Grigorios

doi:10.1148/radiol.15141110

Cited by 25 publications

(23 citation statements)

References 36 publications

(25 reference statements)

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“…Furthermore, growing body of evidence suggests that elevated eCAT volume is independently associated with increased incidence of future myocardial infarction [ 11 – 13 ]. High-sensitive Troponin T (hs-TnT), on the other hand, is a sensitive biomarker of myocardial injury associated with high-risk coronary lesions and plaque burden and provides incremental value for the prediction of cardiac outcome in patients with both presumably stable CAD and preserved systolic left ventricular function [ 14 – 17 ]. Hs-CRP is a surrogate of inflammation associated with CAD and cardiac outcome [ 15 , 17 – 19 ].…”

Section: Introductionmentioning

confidence: 99%

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

et al. 2016

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ObjectivesWe sought to investigate the association of epicardial adipose tissue (eCAT) volume with plaque burden, circulating biomarkers and cardiac outcomes in patients with intermediate risk for coronary artery disease (CAD).Methods and Results177 consecutive outpatients at intermediate risk for CAD and completed biomarker analysis including high-sensitive Troponin T (hs-TnT) and hs-CRP underwent 256-slice cardiac computed tomography angiography (CCTA) between June 2008 and October 2011. Patients with lumen narrowing ≥50% exhibited significantly higher eCAT volume than patients without any CAD or lumen narrowing <50% (median (interquartile range, IQR): 108 (73–167) cm3 vs. 119 (82–196) cm3, p = 0.04). Multivariate regression analysis demonstrated an independent association eCAT volume with plaque burden by number of lesions (R2 = 0.22, rpartial = 0.29, p = 0.026) and CAD severity by lumen narrowing (R2 = 0.22, rpartial = 0.23, p = 0.038) after adjustment for age, diabetes mellitus, hyperlidipemia, body-mass-index (BMI), hs-CRP and hs-TnT. Univariate Cox proportional hazards regression analysis identified a significant association for both increased eCAT volume and maximal lumen narrowing with all cardiac events. Multivariate Cox proportional hazards regression analysis revealed an independent association of increased eCAT volume with all cardiac events after adjustment for age, >3 risk factors, presence of CAD, hs-CRP and hs-TnT.ConclusionEpicardial adipose tissue volume is independently associated with plaque burden and maximum luminal narrowing by CCTA and may serve as an independent predictor for cardiac outcomes in patients at intermediate risk for CAD.

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Section: Introductionmentioning

confidence: 99%

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

et al. 2016

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“…Coronary computed tomography angiography (CCTA) is an excellent non-invasive tool providing detailed insights into coronary artery plaque morphology in patients with coronary artery disease [16,17]. Other than invasive coronary angiography, CCTA may not only describe narrowing of the vessel lumen, but also give insight into plaque morphology, the degree of calcification, and vascular remodeling, which are of prognostic relevance [17,18].…”

Section: Introductionmentioning

confidence: 99%

“…Other than invasive coronary angiography, CCTA may not only describe narrowing of the vessel lumen, but also give insight into plaque morphology, the degree of calcification, and vascular remodeling, which are of prognostic relevance [17,18].…”

Section: Introductionmentioning

confidence: 99%

Galectin-3 binding protein plasma levels are associated with long-term mortality in coronary artery disease independent of plaque morphology

et al. 2016

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“…Additionally, CT calcium scoring does not quantify the burden of noncalcified plaque, leading to interest in the use of contrast CT imaging. This allows measurement of the total coronary plaque burden, which also provides important prognostic information, refining the prediction of cardiac death and recurrent MI in intermediate-risk patients (23).…”

Section: Coronary Plaque Burdenmentioning

confidence: 99%

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

Dweck

Williams

Moss

et al. 2016

Journal of the American College of Cardiology

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Ischemic heart disease is a complex disease process caused by the development of coronary atherosclerosis, with downstream effects on the left ventricular myocardium. It is characterized by a long preclinical phase, abrupt development of myocardial infarction, and more chronic disease states such as stable angina and ischemic cardiomyopathy. Recent advances in computed tomography (CT) and cardiac magnetic resonance (CMR) now allow detailed imaging of each of these different phases of the disease, potentially allowing ischemic heart disease to be tracked during a patient’s lifetime. In particular, CT has emerged as the noninvasive modality of choice for imaging the coronary arteries, whereas CMR offers detailed assessments of myocardial perfusion, viability, and function. The clinical utility of these techniques is increasingly being supported by robust randomized controlled trial data, although the widespread adoption of cardiac CT and CMR will require further evidence of clinical efficacy and cost effectiveness.

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Combined Assessment of High-Sensitivity Troponin T and Noninvasive Coronary Plaque Composition for the Prediction of Cardiac Outcomes

Abstract: Use of hsTnT as a marker of myocardial microinjury and cardiac CT angiography as a marker of the total atherosclerotic burden improves the prediction of cardiac outcome in patients with presumably stable CAD and may aid in personalized risk stratification in patients at intermediate risk.

Cited by 25 publications

References 36 publications

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

Epicardial Adipose Tissue Is Associated with Plaque Burden and Composition and Provides Incremental Value for the Prediction of Cardiac Outcome. A Clinical Cardiac Computed Tomography Angiography Study

Galectin-3 binding protein plasma levels are associated with long-term mortality in coronary artery disease independent of plaque morphology

Computed Tomography and Cardiac Magnetic Resonance in Ischemic Heart Disease

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